Attachment 4
Course Action Request Form
Tennessee State University
Nashville, Tennessee
School/College/Institute_______________ Department ____________ Discipline ____________
PROPOSAL TO:
____
____
____
____
____
____
____
Establish a New Course
Discontinue a Course
Change Number/Title of a Course
Change Course Description or Prerequisites
Change Course Credit Hours
Establish Alternative Delivery System/Course
Cross Listing of a Course
Proposed Effective Date for Requested Action (Semester and Year)_________
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Present Course Title:
______________________________
Present Course No:
______________________________
Present Credit Hours:
______________________________
Proposed Course Title: (list SAME if no changes) __________
Proposed Course No.: (list SAME if no changes) __________
Proposed Credit Hours: (list SAME if no changes) ___________
Effective Term of Action: (Semester and Year): ____________
Hegis Taxonomy Code:
_______________________
Academic Enrollment Ceiling Limit:
_______________________
Grading Scheme:
_______________________
Organizational Responsibility:
_______________________
Funding Source
_______________________
Instructional Medium/ Media
_______________________
Weekly Contact Hours
_______________________
Weeks Duration______
Rationale for Change
Catalog Descriptions (Including prerequisites):

Present Catalog Description (including credit hours, prerequisites):

Proposed Catalog Description (including credit hours, prerequisites):
(list NO CHANGES if no changes in description written above)
Further Information Required

If Establishing a New course:
- Indicate the projected enrollment in the course, justify the course in terms of student
need, and the relationship to other courses in the departmental curricula (core, major,
elective, etc.) and to the total educational curricula of the university;
- If a comparable course is offered in another unit, justify any duplication;
- Will the course be adding hours or substituting hours in a curriculum?
-Include Proposed Catalog Description (including credit hours, prerequisites

For changes in existing courses, indicate how the change will affect the departmental
curriculum and/or the total educational curricula of the university.

For Dual listed (undergraduate/graduate courses) course outline must demonstrate a
substantial difference between undergraduate and graduate components, and must
ensure appropriate attention to both groups. Graduate study must be at a level of
complexity and specialization that extends the knowledge and intellectual maturity of the
student, must require graduate students to analyze, explore, question, reconsider and
synthesize old and new knowledge and skill (SACS 4.3.4)
Special Features

List programs presently being offered for which this course will be used to meet
requirements.

Provide a list of faculty members who may teach the course and their qualifications.

Discuss any special physical facilities needed to support the proposed new course, such
as laboratories, teaching and research equipment, seminar room etc.

If the course is in an area in which professional certification is advisable, explain how the
course will contribute to certification.

Projected new costs associated with the course, including facilities, faculty, library,
research and teaching supplies, travel expenses, technical assistance, or other related
expenses.
Note: Attach a Course Outline including the general and specific objectives, clinical or
experiential components outline of course topics, activities required of students, evaluation
procedures.
CARF Approvals
Dept. Curriculum
& Instruction Committee
Chair
Date
Head of the
Department:
Date
College /School. Curriculum
& Instruction Committee
Dean
Chair
_______________________
Date
______________
Date
Chair
Date
Chair
Date
Vice President for
Academic Affairs
Date
Faculty Senate
Graduate Council
(For graduate courses only)
Final Approval:
Copies of final approved document go to Dean, Admissions and Records and Dean, Graduate
School for information and dissemination into SIS + System.
Dean of OAR
___________________
Date Received in OAR/ Scheduling _______________
Action Taken
___________________
Approved VPAA- April 21, 2003
Revised 11/8/03